Medicare Overview

Medicare is a federal health insurance program designed to provide coverage for millions of Americans. This overview will help you understand the basics of Medicare, its different parts, and how to choose the best coverage for your needs.

• People age 65 and older
• Younger individuals with certain disabilities
• People with End-Stage Renal Disease (ESRD)

Part A (Hospital Insurance)

• Covers inpatient hospital stays
• Skilled nursing facility care
• Some home health care
• Hospice care

Part B (Medical Insurance)

• Covers doctor visits
• Outpatient care
• Medical supplies
• Preventive service

Part C (Medicare Advantage)

• Private insurance plans that bundle Parts A, B, and often D
• May offer additional benefits not covered by Original Medicare
• An alternative way to receive your Medicare benefits

Part D (Prescription Drug Coverage)

• Helps with the cost of prescription medications
• Can be added to Original Med

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You have two main paths for Medicare coverage:

1. Original Medicare (Parts A & B)
   • Offers access to all providers who accept Medicare payments.
   • Allows you to see any doctor or specialist without a referral.
   • May have gaps in coverage that can be filled with supplemental plans.

Additional coverage options:

• Medigap (Medicare Supplement Insurance): Helps cover out-of-pocket costs for Original Medicare
• Part D: Add a separate prescription drug plan

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2. Medicare Advantage (Part C)
   • Often includes prescription drug coverage (Part D).
   • May offer additional benefits like dental, vision, and hearing coverage.
   • Usually has network restrictions (HMO or PPO plans)
   • May offer lower out-of-pocket costs compared to Original Medicare.

• Even with Medicare, you may have out-of-pocket costs such as deductibles, copayments, and coinsurance
• Plans, costs, and benefits can vary significantly by location and provider.
• Your health needs, budget, and preferred doctors should all factor into your decision.
• You may have specific enrollment periods to join or change plans

• Learn More: Visit Medicare.gov for official information.​
• Compare Plans: Use the Medicare Plan Finder tool on Medicare.gov​
• Expert Guidance: Contact a licensed insurance agent at EIC for a free, no-obligation consultation.​
• Timing Matters: Understanding Medicare early empowers you to make the best decisions for your health and budget ​

• Initial Enrollment Period: Begins 3 months before your 65th birthday month and ends 3 months after.
• Annual Enrollment Period: October 15th - December 7th each year
• Special Enrollment Periods: May apply in certain situations (e.g., moving, losing other coverage).

Don't wait until the last minute to explore your Medicare options. Start your research early to ensure you have the coverage you need when you need it.

Navigating Medicare can be complex. At Encore Insurance Connection, out licensed specialists are here to help you understand your options and find the coverage that best fits your needs and budget.

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Remember, there's no one-size-fits-all solution when it comes to Medicare. Your individual health needs, financial situation, and preferences will guide you to the best choice for you unique circumstances.